@Article{信息:doi 10.2196 / / jmir。9690，作者=“Wallin, Emma and Norlund, Fredrika and Olsson, Erik Martin Gustaf and Burell, Gunilla and Held, Claes and Carlsson, Tommy”，标题=“治疗活动，用户满意度，以及基于互联网的认知行为疗法对成人心肌梗死后抑郁和焦虑的可用性:混合方法研究”，期刊=“J Med Internet Res”，年=“2018”，月=“3”，日=“16”，卷=“20”，数=“3”，页=“e87”，关键词=“心理健康;互联网;认知行为疗法;计算机辅助治疗;心肌梗死;磨损;背景:关于用户体验的知识可能会导致关于如何改善基于互联网的认知行为疗法(iCBT)的治疗活动以减少躯体疾病患者的抑郁和焦虑症状的见解。有必要在随机试验的同时进行研究，以探索与此类干预措施相关的治疗活动和用户体验，特别是在常规护理招募的老年患者中。目的:该研究的目的是探讨U-CARE心脏研究中分配到治疗的患者的治疗活动、用户满意度和可用性体验，这是一项针对近期心肌梗死后抑郁和焦虑的iCBT干预的随机临床试验。 Methods: This was a mixed methods study where quantitative and qualitative approaches were used. Patients were recruited consecutively from 25 cardiac clinics in Sweden. The study included 117 patients allocated to 14 weeks of an iCBT intervention in the U-CARE Heart study. Quantitative data about treatment activity and therapist communication were collected through logged user patterns, which were analyzed with descriptive statistics. Qualitative data with regard to positive and negative experiences, and suggestions for improvements concerning the intervention, were collected through semistructured interviews with 21 patients in the treatment arm after follow-up. The interviews were analyzed with qualitative manifest content analysis. Results: Treatment activity was low with regard to number of completed modules (mean 0.76, SD 0.93, range 0-5) and completed assignments (mean 3.09, SD 4.05, range 0-29). Most of the participants initiated the introduction module (113/117, 96.6{\%}), and about half (63/117, 53.9{\%}) of all participants completed the introductory module, but only 18 (15.4{\%}, 18/117) continued to work with any of the remaining 10 modules, and each of the remaining modules was completed by 7 or less of the participants. On average, patients sent less than 2 internal messages to their therapist during the intervention (mean 1.42, SD 2.56, range 0-16). Interviews revealed different preferences with regard to the internet-based portal, the content of the treatment program, and the therapist communication. Aspects related to the personal situation and required skills included unpleasant emotions evoked by the intervention, lack of time, and technical difficulties. Conclusions: Patients with a recent myocardial infarction and symptoms of depression and anxiety showed low treatment activity in this guided iCBT intervention with regard to completed modules, completed assignments, and internal messages sent to their therapist. The findings call attention to the need for researchers to carefully consider the preferences, personal situation, and technical skills of the end users during the development of these interventions. The study indicates several challenges that need to be addressed to improve treatment activity, user satisfaction, and usability in internet-based interventions in this population. ", issn="1438-8871", doi="10.2196/jmir.9690", url="//www.mybigtv.com/2018/3/e87/", url="https://doi.org/10.2196/jmir.9690", url="http://www.ncbi.nlm.nih.gov/pubmed/29549067" }